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HCV subtype 1a and genotypes 3 and 4 were closely associated with male gender, parenteral route of infection, and HIV and HBV coinfection; in contrast, subtype 1b and genotype 2 were associated with female gender, non-parenteral route and mono-infection. Age was related to genotype distribution, and different patterns of distribution and biodiversity index were observed between different geographical areas. Finally, we describe how treatment and changes in transmission routes may have affected HCV genotype prevalence and distribution patterns.

CONCLUSIONS: We present the most recent data on molecular epidemiology of hepatitis C virus in Spain. This study confirms that genotype distributions vary with age, sex, HIV and HBV-coinfection and within geographical areas and epidemiological groups.